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Sovan Sarang Dhar
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P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.01-21 - Metastatic Lung Carcinoma —An Institutional Experience from Eastern India (ID 13260)
12:00 - 13:30 | Author(s): Sovan Sarang Dhar
- Abstract
Background
Carcinoma lung carries poor prognosis and is the leading cause of death among all malignancies.In developing countries like India,two-third of patients present with advanced stage of disease,where survival is dismal.Hence a retrospective study was planned to be conducted to observe the clinicopathological profile of patients presenting with metastatic lung carcinoma and to analyse the treatment response and survival in these cases.
a9ded1e5ce5d75814730bb4caaf49419 Method
A retrospective analysis was done from hospital files of patients with metastatic carcinoma lung presenting to our hospital from January 2015 to April 2018.
4c3880bb027f159e801041b1021e88e8 Result
Out of 55 patients of metastatic lung carcinoma ,36(65%) were male and 19(35%) were female.Majority of the patients were of elderly age group >60yrs i.e 47%(36patients),followed by 40-60yrs age group i.e 31%(17 patients).Considering laterality of primary malignancy,right lung was more commonly affected than left lung(60% vs 40%).Histopathologically adenocarcinoma was the most common variety encountered(85.45%,47 patients) followed by squamous cell variety(0.9%,5 patients).Among 47 patients of adenocarcinoma variety,20 patients(42.5%)have EGFR mutations,whereas 27 patients(57.5%) were EGFR nonmutated.The pattern of metastases shows single organ metastasis in 19 patients(34.5%) and multiple organ metastases in 36 patients(65.5%). Overall bone was the most common site(25 patients) of metastases whereas brain was the most common single organ metastasis site.The followup period ranged from 2months to 40 months(median followup period-7mnths).One year and two year overall survival was 30% and 10.9% respectively.Subgroup analysis between patients who have received Tyrosine Kinase Inhibitors(TKI)±chemotherapy group and those who have received chemotherapy only group showed median overall survival of 19 months vs 6mnths respectively.
8eea62084ca7e541d918e823422bd82e Conclusion
Inspite of increased awareness,incidence of metastatic lung carcinoma is still high.Adenocarcinoma is the most common histopathological variety.Bone,contralateral lung and brain were the common organs involved by metastases.EGFR mutation status should be assessed in all cases of adenocarcinoma lung.Adding TKI in EGFR mutated cases has shown increased survival in our study.Larger sample size and longer followup period can further validify the results.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.CR - Case Reports (Not CME Accredited Session) (ID 984)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.CR-02 - SBRT of Lung Primary After Complete Resolution of Metastatic Disease in Case of EGFR Mutated Adenocarcinoma Lung: A Case Report (ID 14464)
12:00 - 13:30 | Author(s): Sovan Sarang Dhar
- Abstract
Background
Lung cancer accounts for the highest malignancy related mortality among males worldwide. The prognosis of metastatic lung cancer is dismal and as per data from United States of America, the 5-year survival of metastatic lung cancer patients stands at mere 5 percent. Loco-regional management in metastatic lung cancer is not routinely practiced, however exceptions are made in patients who have very good response to systemic treatment. In such cases loco-regional treatment is expected to improve disease free survival.
a9ded1e5ce5d75814730bb4caaf49419 Method
Section Not applicable
4c3880bb027f159e801041b1021e88e8 Result
Fifty-six year old male, known hypothyroid[on thyroxine supplementation] without any significant history of addiction/family history presented with chronic non-productive cough and acute breathlessness. On evaluation left lung upper lobe primary mass [adenocarcinoma on histopathology] and left sided pleural and pericardial effusion[malignant on cytology]as well as multiple cervical lymphadenopathy was found on PET-CT. Hundred percent of the primary tumour tissue was found to harbour EGFR mutation while being negative for ALK mutation. After six cycles of chemotherapy with Carboplatin and Pemetrexed combination chemotherapy regimen, the patient was kept on Erlotinib for 9 months. All the metastatic diseases were found to be resolved and primary was shrunken on assessment PET-CT. Patient was advised for SBRT to primary 50Gy in 5 fractions,10Gy per fraction on alternate days over a period of 10 days following which he has been kept on Tab Erlotinib. The patient has a survival of 18 months calculated from the time of diagnosis till compilation of data and is disease free.
8eea62084ca7e541d918e823422bd82e Conclusion
High percentage of EGFR mutation can provide very good response to tyrosine kinase inhibitor therapy in case of metastatic adenocarcinoma lung. Partial response at primary with resolution of metastatic disease throws a challenge for use of loco-regional modality of management in tandem with systemic treatment.
6f8b794f3246b0c1e1780bb4d4d5dc53
